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OUN NK PROGRAM OFFICIAL INSPE ON REPORT (� Z <br /> UNDERGR <br /> AN JOAQUIN HEALTH DISTRICT 0 <br /> 1601 E. HAZELTON AVE. <br /> STOCKTON, CA 95205 COONTY # I <br /> COUNTY NAME PHONE NO. 468-3423 <br /> SITE NAME: �� 5gff T°( I(AO-rO �L � s)"/ Co INSPECTION DATE: �8� O <br /> SITE ADDRESS: 2 fc�� � r � �RX CITY/STATE/ZI (53 76 <br /> CHANGES SITE/OWNER/PERMIT? YES NO TANK TANK TANK TANK <br /> FORM AAND/OR B SUBMITTED? COMPu R COMPUTER COMPUTER COMPUTER <br /> NUMBER�L o^I NUMBER NUMBER NUMBER <br /> TYPE F INSPECTION SITE COMPUTER# PER # /'' L�" PER# <br /> '% PER# PER# <br /> y � EXP.DATED) EXP.DATE EXP.DATE EXP.DATE <br /> TAN <br /> OPERATIONAL TANK MAJOR OR MMINOR <br /> PERMIT TO OPERATE 1 2 <br /> CHANGE IN CONDITIONS TO OPERATE 3 4 --- <br /> APPROVED CONSTRUCTION 5 6 <br /> WRITTEN MONITORING PROCEDURES 7 8 - -- <br /> APPROVED MONITORING SYSTEM 9 10 <br /> MONITORING SYSTEM 11 12 -"- <br /> APPROVED MONITOR FREQUENCY 13 14 <br /> MONITORING RECORDS MAINTAINED 15 16 - <br /> ACCESS CASING SECURED 17 18 <br /> PIPING 19 20 --- <br /> INVENTORY RECONCILIATION 21 22 <br /> TANK GAUGING 23 24 <br /> APPROVED RESPONSE PLAN 25 26 --- <br /> UNAUTHORIZED RELEASE OCCURRENCE 27 28 --- <br /> SAMPLING 29 30 --- <br /> APPROVED TANK REPAIRS 31 32 -- <br /> UNAUTHORIZED RELEASES REPORTED 33 34 -- -- --- <br /> SAFETY HAZARD 35 36 -_. ...._._ _....--�._ _.._.. ..__ <br /> CONDITIONS ABATED 37 <br /> TEMPORARY TANK CLOSURE <br /> REMOVAL OF RESIDUAL 38 39 <br /> FLAMMABLE VAPORS REMOVED 40 <br /> ACCESS LOCATIONS SEALED 41 42 <br /> POWER DISCONNECTED 43 <br /> OWNER/OPERATOR MONITORING 44 45 - <br /> PERMANENT TANK CLOSURE <br /> REMOVAL OF RESIDUAL MATERIALS Lc <br /> PIPING FLAMMABLE VAPORS REMOVED UNAUTHORIZED RELEASE SAMPLING IMPROPER ABANDONMENT <br /> 1 1 <br /> THE MARKED ITEMS REPRESENT VIOLATIONS AND MUST BE CORRECTED AS <br /> SYSTEM STATUS(MUST MARK ONE) FOLLOWS: <br /> MAJOR 57 MINOR 68 NO 59 /IZ <br /> VIOL. VIOL. ❑ VIOL.❑ <br /> ---------------- <br /> OFFICE: INSP: J RECEIV D BY: <br /> TITLE: �F H 51 PHONE: R CK: <br /> 5/88 <br /> HUT-3 ORIGINAL <br />